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Search › Colorado › 171100000X

Jodie Mactavish

NPI 1366733545 · on the registry since 2011 · sole proprietor

Practice

Address
3096 I-70 Business Loop
Suite D
Grand Junction, CO 81504
Phone
(970) 434-8500
Fax
(970) 434-8500
Organisation at this address
Obsidian Medical Llc
Aspen Grove Family Practice, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Registry record

Primary taxonomy
171100000X
171100000X
Also registered as
173C00000X
Licence states on file
CO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2011-04-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado